To investigate hearing outcomes after stapes surgery in children with stapes fixation.
Retrospective study.
Tertiary referral center.
Forty-nine patients (66 ears) aged less than 15?years who received stapes surgery.
Stapes surgery.
Preoperative symptoms, bilateral involvement, pure-tone hearing levels, and perioperative complications were analyzed using paired t test and Mann-Whitney U test.
The chief complaint of all patients was hearing disturbance. Sixteen ears were diagnosed with stapes fixation and an additional congenital ossicular anomaly and 50 ears had only stapes fixation. Preoperative mean bone conduction and air conduction thresholds were 12.0?±?5.8?dB and 60.9?±?10.9?dB, respectively. The mean air-bone gap (ABG) was 48.9?±?12.0?dB in patients with stapes fixation and an ossicular anomaly. The postoperative mean ABG was 23.6?±?14.5?dB, and the ABG closure was 25.3?±?18.2?dB. In patients with stapes fixation only, the preoperative mean bone conduction and air conduction thresholds were 14.3?±?7.5?dB and 49.6?±?9.5?dB, respectively, and the mean ABG was 35.5?±?9.6?dB. The postoperative mean ABG was 14.4?±?10.3?dB, and the ABG closure was 16.2?±?16.1?dB. The successful results (ABG &lt;20?dB) were 75.8% overall, 56.3% for fixation and an ossicular anomaly, and 82.0% for fixation only.
In children with stapes fixation, hearing loss was worse when the fixation was combined with an ossicular anomaly. Ossicular continuity, especially of the incus, is the most important factor for successful stapes surgery. Appropriate diagnosis and surgical intervention can lead to good results for children with stapes fixation.
In children with stapes fixation, hearing loss was worse when the fixation was combined with an ossicular anomaly. Ossicular continuity, especially of the incus, is the most important factor for successful stapes surgery. Appropriate diagnosis and surgical intervention can lead to good results for children with stapes fixation.To describe a new method to measure the cochlear parameters using Otoplan software, and to compare it with the traditional method using curved multiplanar reconstruction (cMPR).
Retrospective analysis using internal consistency reliability and paired sample t test.
Tertiary referral center.
Thirty-four patients including 68 ears from a clinical trial were retrospectively reviewed.
The length, width, height (distances A, B, H), and cochlear duct length of each cochlea were measured independently using two modalities Otoplan and cMPR. Internal consistency reliability of the two modalities was analyzed. The time spent on each measurement was also recorded.
Otoplan software was compatible with all radiological data in this series. Distances A, B, and H showed no significant differences between Otoplan (9.33?±?0.365, 6.61?±?0.359, and 2.91?±?0.312 mm) and cMPR (9.32?±?0.314, 6.59?±?0.342, and 2.93?±?0.250 mm). The average cochlear duct length calculated by Otoplan was 34.37?±?1.481 mm, which was not significantly different from that calculated by cMPR (34.55?±?1.903mm, p?=?0.215). The measurements with Otoplan had better internal consistency reliability compared with those by cMPR, and measurements with a higher peak kilovoltage (140 kVp) CT scan showed further higher internal consistency reliability. Time spent on each cochlea by Otoplan was 5.9?±?0.69 min, significantly shorter than that by cMPR (9.3?±?0.72 min).
Otoplan provides more rapid and reliable measurement of the cochlea than cMPR. Furthermore, it can be easily used in the laptop computer.
Otoplan provides more rapid and reliable measurement of the cochlea than cMPR. Furthermore, it can be easily used in the laptop computer.Ocular vestibular evoked myogenic potentials (oVEMP) testing in response to air-conducted sound (ACS) has excellent sensitivity and specificity for superior semicircular canal dehiscence syndrome (SCDS). However, patients with SCDS may experience vertigo with the test, and recent works recommend minimizing acoustic energy during VEMP testing.
To develop an oVEMP protocol that reduces discomfort and increases safety without compromising reliability.
Subjects Fifteen patients diagnosed with SCDS based on clinical presentation, audiometry, standard VEMP testing, and computed tomography (CT) imaging. There were 17 SCDS-affected ears and 13 unaffected ears. In nine (53%) of the SCDS-affected ears surgical repair was indicated, and SCD was confirmed in each. oVEMPs were recorded in response to ACS using 500?Hz tone bursts or clicks. oVEMP amplitudes evoked by 100 stimuli (standard protocol) were compared with experimental protocols with only 40 or 20 stimuli.
In all three protocols, oVEMP amplitudes in SCDS-affected ears were significantly higher than in the unaffected ears (p?&lt;?0.001). 500?Hz tone bursts evoked oVEMPs with excellent (&gt;90%) sensitivity and specificity in each of the three protocols. However, in the unaffected ears, lowering to 20 stimuli reduced the detection of oVEMP responses in some ears. Following surgical repair, oVEMPs normalized in each of the protocols.
In oVEMP testing using ACS for SCDS, reducing the number of trials from 100 to 40 stimuli results in a more tolerable and theoretically safer test without compromising its effectiveness for the diagnosis of SCDS. Reducing to 20 stimuli may degrade specificity with clicks.
In oVEMP testing using ACS for SCDS, reducing the number of trials from 100 to 40 stimuli results in a more tolerable and theoretically safer test without compromising its effectiveness for the diagnosis of SCDS. Reducing to 20 stimuli may degrade specificity with clicks.To analyze audiometric data after surgical manipulation of the membranous labyrinth during plugging of superior semicircular canal dehiscence (SSCD) or posterior semicircular canal occlusion (PSCO) for benign paroxysmal positional vertigo.
Retrospective chart review.
Tertiary referral center.
Patients undergoing plugging of SSCD or PSCO between 2009 and 2019.
Pre- and postoperative audiometric data were collected per AAO-HNS guidelines. Hearing outcomes at initial and last follow-up were compared. Subanalyses were performed for surgical approach and age.
Eighty-seven total procedures in 76 patients including 43 middle cranial fossa for SSCD, 29 transmastoid SSCD, and 15 PSCO. Mean preoperative air-conduction-pure-tone averages was 21.1±14.9?dB compared with 26.1?±?19.6?dB at initial follow-up and 24.4?±?18.6?dB at last follow-up (p?=?0.006). https://www.selleckchem.com/products/deg-77.html Mean preoperative bone-conduction-pure-tone average was 14.3?±?11.9?dB compared with 18.3?±?15.6?dB at initial follow-up and 18.5?±?16.9?dB at last follow-up (p?&lt;?0.